Treatment of Resistant Hypertension in the Patient With Chronic Kidney Disease

• We discuss the impact and global burden of poorly controlled hypertension
• We review the pathophysiology of chronic renal disease and its association with worsening hypertension
• We discuss the complex reciprocal interaction between hypertension and chronic kidney disease
• We define clinical inertia and discuss its impact on hypertension management.
• We review evidence-based management of hypertension in the patient with chronic kidney disease

The burden of risk and the impact of disease associated with poorly controlled hypertension in the United States population presents significant challenges to primary care providers, including nurse practitioners. The lack of blood pressure control leads to a staggering number of premature deaths annually. To reduce risk for major cardiovascular events, aggressive approaches to treatment of resistant hypertension must be considered. Hypertension plays a key role in the progression of chronic kidney disease. The goal of treating resistant hypertension must be directed at reducing cardiovascular risk while preserving renal function.